사이버나이프 SynchronyTM 호흡 추적 장치를 이용한 폐종양 방사선수술의 유용성 평가
Evaluation on the Usefulness of Lung Tumor Stereotactic Radiosurgery Applying the CyberKnife SynchronyTM Respiratory Tracking System
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초록
본 연구는 사이버나이프 Synchrony 호흡추적 장치를 이용하여 방사선 수술을 시행한 폐종양 환자 48명을 대상으로 전 치료기간 중 종양의 움직임과 방사선수술의 정확성을 평가하였다. 폐종양의 움직임은 종양이나 종양주변에 삽입된 금침의 좌표를 사이버나이프 영상유도 장치로 측정하였으며, 방사선수술의 정확성은 움직임 추적 컴퓨터(MTS)로 계산된 상관관계 오차로 평가하였다. 폐종양의 움직임은 두미방향으로 평균 2.63± 1.87mm며, 좌우방향 1.13±0.71mm, 전후방향 1.74±1.16mm의 움직임을 보였으며, 회전 움직임 정도는 X축 1.66±1.66°, Y축 1.20±0.97°, Z축 1.18±0.73°로 측정되었다. 직선 움직임의 벡터 값은 평균 3.78± 2.00mm값을 나타냈다. 연구 결과에서 두미방향(p<0.001)과 전후방향(p<0.029), 3차원 벡터 값(p<0.002)들은 종양의 위치가 상부보다 하부의 움직임이 크게 나타나 통계적 유의성을 보였다. 사이버나이프 Synchrony 호흡추적 장치를 이용한 폐종양의 방사선 수술시 상관관계 오차는 전체 평균 0.95±0.62mm로 매우 정확한 조사로 종양의 움직임을 보상하여 방사선 수술이 이루어졌으며 그 유용성을 확인할 수 있었다.
Abstract
This study evaluated the motion of tumors during the entire period of therapy and the accuracy of radiosurgery among forty eight lung tumor patients who were underwent radiosurgery using the CyberKnife Synchrony Respiratory Tracking System. The motion of lung tumor was measured by the coordinates of a gold acupuncture needle inserted into the tumor or the area around the tumor using the CyberKnife image guided system. Then the accuracy of radiosurgery was evaluated based on the error of correlation computed with the motion tracking system. The lung tumor motion is Cranio-Caudal direction by an average of 2.63±1.87mm, moved left-right direction by 1.13±0.71mm, and anterior-posterior direction by 1.74±1.16mm. The degree of rotational movement was 1.66±1.66° on X axis, 1.20±0.97° on Y axis, and 1.18±0.73° on Z axis. The vector of translation movement was measured to be 3.78±2.00mm on the average. The results show that directions of Cranio-Caudal(p<0.001), anterior-posterior direction(p<0.029), and three dimensional vector value(p<0.002) showed statistical significance, because the lower side of tumor showed more intensive movement compared to the upper side of tumor. The radiosurgery was carried out by compensating the motion of tumor after accurate investigation of the correlation error with the average of 0.95±0.62mm during the lung tumor radiosurgery with the CyberKnife Synchrony Respiratory Tracking System.
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